Systematic review of involuntary hospitalisation and long-term compliance

Abstract

Introduction

Involuntary hospitalisation denies autonomy and freedom of decision-making and is frequent in psychiatric clinical practice. However, there is still a lack of knowledge of long-term compliance after Involuntary commitment.

Methods

We conducted a systematic review of published studies reporting people compliance after involuntary hospitalisation and people compliance after voluntary admission. Two investigators independently searched PubMed, PsycINFO, EMBASE and CINAHL up to December 17th, 2021 to identify eligible studies. The study is registered with PROSPERO number CRD42022299437.

Results

Ten independent studies analysing the main indicators of compliance, engagement with services and medication adherence, were included. Three studies show that compliance is worse in people that have been involuntary hospitalised and in the others no association is found. Just two of the ten studies show an association with improved compliance. Outcomes are assessed from the first follow-up appointment after discharge up to 96 months.

Conclusions

Although evidences carried out so far are weak, the data do not show a trend of improvements and do not seem to exclude the possibility of worse compliance after compulsory hospitalisation. More appropriate methodologies and reliable assessment are needed in future research to provide scientific evidence on involuntary admission health effects.

Keywords:

• Involuntary hospitalisation
• compliance
• coercion
• engagement
• medication adherence
• long term outcomes

Disclosure statement

The authors report no conflicts of interest.

Geolocation information

Sardinia, Italy.

Data availability statement

All data generated or analysed during this study are included in this published article.

Additional information

Funding

This work was supported by P.O.R. SARDEGNA F.S.E. 2014–2020 – Axis III "Education and Training, Thematic Objective: 10, Specific Objective: 10.5, Action of the fi Partnership Agreement: 10.5.12 "Call for proposals for the funding of research projects – Year 2017.”